Medicaid Planning is already a major concern for a lot of families. Unfortunately, there are also a lot of sources – legal, financial, websites – that stoke the fire that “you’re going to lose everything to a nursing home/government.”
INDIANA MEDICAID WAIT LIST: THE SHORT VERSION
- Indiana Medicaid has cut programs and created wait lists. For some home and community-based services, the wait is 12 to 18 months or more. Medicaid may not be there when you need it.
- While you wait for a waiver slot, those services are generally private pay. Planning fees do not change that.
- Many families need less planning than they are told. Some assets do not count, and income can often be handled with minor planning.
- Talk with your financial advisor before you move assets. The tax consequences are worth understanding first.
The premise of stoking that fear is that those entities – certain lawyers, annuity companies, and other professional services companies – need to create that concern so they can sell solutions. Those solutions can cost families tens of thousands of dollars in attorney’s fees, taxes, and other charges. In some cases, those fees will cost a family more than they would ever spend in a nursing home.
Ultimately, this planning is “to protect assets” from long-term care expenses with the plan for Medicaid to pay those expenses.
INDIANA MEDICAID IS BROKE AND BROKEN
What they do not explain is that Indiana Medicaid is broken.
It has “resolved its insolvency, sort of. It substantially reduced and cut available programs, made the application and reapplication process longer and more convoluted, and has created 12-18 month or more wait lists for many of its services. As of September 2026, 12,266 people are on the PathWays wait list. Another 6,920 are on the Health and Wellness list. Maybe you’ve heard about the work requirement rules in the news for some people on Indiana Medicaid. There isn’t a work requirement for long-term care Medicaid. However, if you are on a wait list, all the money spent in planning fees cannot do anything because those services must be private paid while on the waiting list.
ASSISTED LIVING IS PRIVATE PAY UNTIL A WAIVER SLOT OPENS
Two other things about this asset protection planning:
One of the Indiana Pathways programs is a limited “assisted living-like” program. You need to qualify for Indiana Medicaid, i.e. Pathways coverage and clear the waitlist. Otherwise, you private pay for the service, even if you are in one of the qualified programs, like Green Oaks, Glasswater Creek, Silver Birch, etc.
These can be great solutions for mom or dad when they are not ready for full nursing home care, but not able to stay more independently anymore. They need some help with meals, less house upkeep/maintenance, and some attention to make sure they are doing okay during the day. It allows independence with oversight.
Until a waiver slot opens, that option is private pay. What’s worse – for people who paid 10s of thousands of dollars to “protect assets” may not have full access to them to cover the private pay period.
There is a challenging balance between the fear that is being stoked that “you are going to lose everything to a nursing home” and to giving your parents the quality of life they want now.
MOST PEOPLE DO NOT SPEND YEARS IN A NURSING HOME
Second, most people do not spend years in a nursing home at the end of their lives.
Actually, most people don’t end up in a nursing home at all.
Even for those who do end up in a nursing home at end of life, many are there less than 6-months:
- Some may die there after a short stay.
- Some may go somewhere else for hospice – even if they stay there for hospice, part of hospice care is covered by Medicare.
- Many people do everything they can, wherever else they can, before their health needs require them to be in a nursing home.
Even when a nursing home is necessary and a family wants/needs to pursue Medicaid, many of them don’t need extensive, quality of life changing planning to gain eligibility. Some assets don’t count as resources. Income “limits” are not an issue, with some minor planning, if needed, to meet Indiana Medicaid eligibility guidelines.
HOW WE APPROACH LONG-TERM CARE PLANNING
We have helped hundreds of families navigate long-term care planning. It is rare for us to charge more than $5,000. Our normal fee range is $3,000 to $4,500, including the application process to a decision. It is very rare for us to make substantial asset ownership changes/transfer to “protect” assets with Asset Protection Trusts or Medicaid-compliant Annuities. We don’t charge $10,000-$25,000 to, as one attorney recently told an advisor I work with: “I need you to send me $20,000 to protect (the clients) from losing everything to a nursing home.” By the way, that is before the tax consequence caused by substantial withdrawals from IRAs to “protect” them.
(PS: in RMD status, IRAs are not a countable resource. Someone may have forgotten to mention that.)
Neither of the couple was on the path to a nursing home, nor did they want it. They have the resources to live the quality of life they want to choose, where they choose.
YOUR FINANCIAL ADVISOR BELONGS IN THE CONVERSATION
Here’s the other thing these planners don’t tell people: financial advisors have many options to address long-term care expenses. Those plans give you more control for when and where you receive care. Plus, it is part of your overall investment strategy that you and your advisor have built for years.
Most attorneys are not licensed to give financial advice.
To be fair, most financial advisors aren’t licensed to give legal advice.
That’s why you should have one of each. Ideally, those two should know and work with each other for you.
Before committing to an aggressive, expensive “protection plan,” check with your financial advisor. Discuss the proposed strategy and tax implications of large withdrawals from IRAs, other deferred assets, or other investments generally. Most people have had a longer relationship their financial advisor than an attorney who they met after a dinner or presentation. You and your advisor have discussed and built your financial plan over years if not decades. You may have even discussed some options if long-term care or other healthcare needs increase. Even if you have worked with the attorney before, you’ve probably talked with your advisor more often over the years.
BEFORE YOU PAY FIVE FIGURES
— I also wonder: if you worked with an attorney prior and he did an estate plan several years ago, charged $4,000-$10,000 then, why does he think paying $10,000 to $20,000 now is going to solve the problem now? What happens in three more years when Medicaid is harder to qualify for or is gone altogether? Medicaid and Nursing Homes have been doing and charging for services for decades.
It’s also important to understand, there are many options to limit long-term expenses in planning, with an attorney or your financial advisor – that don’t substantially change your quality of life now.
We work with a lot of clients and planning as part of the application process when LTC needs happen without a lot warning, too.
Before you pay five figures on a hedge, take a moment and check with your trusted advisor who has grown with you for years. There may be better, less expensive options to consider.
The planning your family needs depends on what your situation actually looks like. The level of planning depends on that.
We’ve written about how to tell the difference: What Medicaid Planning Is and Why People Overpay for It
QUESTIONS PEOPLE ASK ABOUT THE INDIANA MEDICAID WAIT LIST
It depends on the program, and the state has said it cannot estimate an individual’s wait. As of September 2026, 12,266 people are on the PathWays wait list and 6,920 on the Health and Wellness list. The state was inviting people who applied about a year or more earlier, and people leaving a nursing facility or hospital move up first.
Generally, you do. The wait list is for home and community-based waiver services, so those services are private pay while you wait. Lawmakers have raised this gap for people who spent down their assets and live in assisted living. Plan how you would pay before moving assets.
Only through a waiver, and the waiver has a wait list. Since July 2025, the state has reserved waiver slots for people already living in assisted living who meet its criteria: 100 on one waiver and 400 on the other, with 6 used as of September 2026.
Not always. Some assets do not count as resources, and income that runs high can often be handled with minor planning.
Yes. Large withdrawals from an IRA or other deferred accounts can create tax consequences, and your advisor knows your whole financial picture. There is no charge for that first conversation with us.
This article is general information, not legal advice. Reading it does not create an attorney-client relationship, and every situation has details that change the answer. For advice about your own situation, talk with a licensed Indiana attorney.
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